WG 2.6 Declaration of criminal record and ... - British Rowing

WG 2.6Declaration of criminal record and application for a Barred List and/orCriminal Records CheckComplete this form if you are a volunteer/employee (see WG 2.5) whose role requires a DBS Disclosure.Because of the nature of the duties you will be expected to perform in your role, you are required to complete a BarredList and/or Criminal Records Check and to disclose details of any unspent criminal convictions, cautions, reprimands orwarnings. Only relevant spent convictions and other information will be taken into account so disclosure need notnecessarily prevent you from working in this role. British Rowing will treat any information you give here in confidence. Itwill be stored and disposed of securely and it will not be used unfairly against you.The amendments to the Exceptions Order 1975 (2013) provide that certain spent convictions and cautions are 'protected'and are not subject to disclosure to employers, and cannot be taken into account. Guidance and criteria on the filtering ofthese cautions and convictions can be found at the Disclosure and Barring Service website.The post you have applied for is exempted from the Rehabilitation of Offenders Act 1974, which means that all unspentconvictions, cautions, reprimands and warnings on your criminal record need to be disclosed.Is the role you will be working in a Regulated Activity? (If you are unsure check with yourCWO or for more information see WG 2.11)If yes, you must request a check against the Barred List.Have you any unspent convictions or cautions, reprimands or warnings?If yes, please give details of offences, penalties and dates below.Are you a person known to any Children’s or Adults’ Services Department as being anactual or potential risk to children/Adults at Risk/other people?If yes, please give full details below.Have you ever been investigated, had a sanction imposed against you or beendisciplined in any way for any matter by a sports or other organisation’s governing bodyrelating to child abuse, abuse of an Adult at Risk, sexual offences, violence or use ofdrugs or alcohol?If yes, please give full details below.Is there any other information that you consider relevant to this application (and whichBritish Rowing is entitled to know) that you would like to bring to our attention?If yes, please give full details below.Name (including any middlenames):Home address:YesYesYesYesYesNoNoNoNoNoPost code:Email address:Rowing Club at which you will becarrying out your role:Contact number (in case ofqueries):Date of birth:British Rowing 6 Lower Mall London W6 9DJ 020 8237 6700 www.britishrowing.org1 of 2 Revised June 2013

Role applied for:Tick as applicableIs the role voluntary or paid?Please state which:British Rowing Membership No:Sports Coach (children)Sports Coach (Adults at Risk)Children’s SupervisorWG 2.12Driver (children)ChaperoneWelfare Officer• I confirm that I have read, understood and agree to abide by British Rowing’s (tick as appropriate):Code of Conduct (WG1.4)Applicable to all applicantsSafeguarding and Protecting Children PolicyApplicable to applicants working with childrenSafeguarding Adults at Risk PolicyApplicable to applicants working with Adults at Risk• I undertake to inform British Rowing’s Lead Safeguarding Officer within 7 days if I receive any new relevantcaution, reprimand, warning or conviction during the period whilst I continue to carry out the role to which thisapplication relates.British Rowing will send your CWO an email with your name and email address.Your CWO will send you a further email with instructions about how to complete an online DBS application.They will arrange to meet with you to verify your identity details.Further information and guidance will be available during the online application process.Please use this space for any further information relating to the questions above.DBS Update Service and PortabilityFrom 17th June 2013, applicants can subscribe to the DBS online Update Service: https://www.gov.uk/dbs-update-serviceIf an individual subscribes to the Update Service, their employer or equivalent (in this case, British Rowing as theorganisation through which the Disclosure was obtained) can go online, with their consent, and carry out a free, instantcheck to find out if the information released on the DBS certificate is current and up-to-date. This service is free forvolunteers, whilst those in paid employment are required to pay a fee of £13.00. The subscription will need to be renewedannually by the individual.We are currently awaiting guidance on how the Updating Service for Disclosures obtained through British Rowing willwork in practice. However, it will involve subscribers providing British Rowing with their certificate number, name anddate of birth, and specifically giving their permission for their Disclosure status to be checked by British Rowing.British Rowing does not accept Portability of Disclosures obtained through other organisations, and is currently awaitingguidance on how the Updating Service for Disclosures obtained through British Rowing will work in practice.British Rowing 6 Lower Mall London W6 9DJ 020 8237 6700 www.britishrowing.org2 of 2 Revised June 2013